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SPARK Reading Donation Form
Are you the student's parent or legal guardian?
*
Yes
No
How many children participated in SPARK?
*
1
2
3
4
How many children are you sponsoring?
*
1
2
3
4
Student 1 Name
*
First
Last
Student 1 - Grade/Teacher
*
Student 1 - Hours Read
*
Student 1 - Donation Amount
*
Student 2 Name
*
First
Last
Student 2 - Grade/Teacher
*
Student 2 - Hours Read
*
Student 2 - Donation Amount
*
Student 3 Name
*
First
Last
Student 3 - Grade/Teacher
*
Student 3 - Hours Read
*
Student 3 - Donation Amount
*
Student 4 Name
*
First
Last
Student 4 - Grade/Teacher
*
Student 4 - Hours Read
*
Student 4 - Donation Amount
*
Contact Information
Name
*
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Phone
*
Email
*
Address
*
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Additional Giving Options
PayPal (Select One)
*
Donate 100% - Add 3% so that 100% of the donation goes to Dilworth Elementary.
Donate 97% - I understand Paypal, Inc. will deduct 3% to cover transaction costs.
Donate 100% - Add 3% so that 100% of the donation goes to Dilworth Elementary.
Price:
$0.00
Is this donation eligible for corporate matching?
No
Yes
Company Name
*
Other
Bank of America
Duke Energy
Wells Fargo
Company Name
*
Donation Total
$0.00
Credit card payments can be done through PayPal
Payment Option
Pay with paypal online (will be directed to Paypal to make payment after form is submitted)
Send check into school
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Paypal
You will be directed to Paypal to make payment after form is submitted.
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